Paris SV, Viti JA Journal of Manual and Manipulative Therapy   2000; 8(1):   25-8


This case study describes how thrust manipulation in the upper thoracic spine was effective in reducing symptoms in a patient with complaint of headache; it discusses potential theories and interrelationships. The study describes a 29-year-old female with onset of occipital headaches who noted no change in symptoms after five treatments over a period of three weeks. Treatment includ ed soft tissue mobilization,passive stretching, postural instruction/exercise and non-thrust manipulation to occipito-atlantal (O/A), atlanto axial (A/A) and cervical facet joints. The patient’s sixth visit, that occurred 5 days after the fifth treatment session, included a thrust manipulation to the upper thoracic spine (T1/2)after which she noted a significant reduction in symptoms. The patient was then seen for two additional visits which included non-thrust manipulation techniques. Two days after her final visit, the patient noted full resolution of symptoms. The patient continued to note full resolution of symptoms for six weeks. The patient then returned to physical therapy with similar complaints but at approximately 50% of the earlier intensity. Two treatments, over a period of one week, utilizing non-thrust manipulation techniques yielding no relief in symptoms. One week later, the patient received a thrust manipulation at %2/3 after which she noted full resolution of symptoms. At follow up,seven weeks later, the patient remained symptom free.

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